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Drugs Acting On Lower Respiratory
Drugs Acting On Lower Respiratory
Characteristics
o Progressive loss of lung compliance and increasing
hypoxia
Causes
o Cardiovascular collapse; major burns; severe
trauma; rapid depressurization
Treatment
o Reversal of the underlying cause combined with
ventilatory support
Actions
o Direct effect on the smooth muscles of the respiratory
tract, both in the bronchi and in the blood vessels
Indications
o Symptomatic relief or prevention of bronchial asthma and
for reversal of bronchospasm associated with COPD
Pharmacokinetics
o Narrow therapeutic margin
o Rapidly absorbed for the GI tract
o Metabolized in the liver and excreted in the urine
Contraindications
o GI problems, coronary disease, respiratory dysfunction,
renal or hepatic disease, alcoholism, or hyperthyroidism
Adverse Effects
o Related to theophylline levels in the blood
o GI upset, nausea, irritability, and tachycardia to seizure,
brain damage, and even death
Drug-to-Drug Interactions
o Many drugs interact with xanthines
o Nicotine increases the metabolism
Assess:
o History and Physical Exam and known allergy
o Peptic ulcer, gastritis, renal or hepatic dysfunction,
and coronary disease
o Monitor blood pressure, pulse, cardiac auscultation,
peripheral perfusion, and baseline electrocardiogram
o Skin, BS, liver and renal function, appropriate lab
values, as well as theophylline levels
Actions
o Beta2 selective adrenergic agonists
Indications
o Acute asthma attach
o Bronchospasm in acute or chronic asthma
o Prevention of exercise-induced asthma
Pharmacokinetics
o Rapidly distributed after injection, transformed in the liver to
metabolites that are excreted in the urine
Contraindications
o Depends on the severity of the underlying condition
Adverse Effects
o Sympathomimetic stimulation
o CNS stimulation
o GI upset, cardiac arrhythmias, hypertension,
bronchospasm, sweating, pallor, and flushing
Drug-to-Drug Interactions
o General anesthetics
Assess:
o History and Physical Exam and known allergy
o Cigarette use, pregnancy and lactation
o Cardiac disease, vascular disease, arrhythmias,
diabetes, and hyperthyroidism
o Reflexes and orientation, VS, reflexes and orientation
and appropriate lab values
True
Caution
o Any condition that would be aggravated by the
anticholinergic effects of the drug
Adverse Effects
o Related to the anticholinergic effects of the drug
o Dizziness, headache, fatigue, nervousness, dry
mouth, sore throat, palpitations, and urinary
retention
Assess:
o History and Physical Exam and known allergy
o Acute bronchospasm, bladder neck obstruction or
prostatic hypertrophy, orientation, affect, and
reflexes
o Pulse and B/P, respirations and adventitious sounds
and urinary output
Actions
o Decrease the inflammatory response in the airway
Indications
o Prevention and treatment of asthma
o Treat chronic steroid-dependent bronchial asthma
Pharmacokinetics
o Well absorbed from the respiratory tract
o Metabolized by natural systems, mostly within the liver,
excreted in the urine
Assess:
o History and Physical Exam and known allergy
o Systemic infections, pregnancy and lactation
o VS, respirations, adventitious sounds, nares
Actions
o Selectively and competitively block or antagonize receptors for
the production of leukotrienes
Indications
o Prophylaxis and chronic treatment of bronchial asthma in adults
and in patients younger than 12 years of age
Pharmacokinetics
o Rapidly absorbed from GI tract, extensively metabolized in the
liver and primarily excreted in feces
Caution
o Hepatic or renal impairment
o Pregnancy and lactation
Adverse Effects
o Headache, dizziness, myalgia, nausea, diarrhea and
abdominal pain, elevated liver enzyme
concentrations, vomiting, and generalized pain
Drug-to-Drug Interactions
o Propranolol, theophylline, terfenadine, or warfarin
o Calcium channel blockers, cyclosporine, or aspirin
Assess:
o History and Physical Exam and known allergy
o Acute bronchospasm or asthmatic attack
o Impaired renal or hepatic function
o Temperature, orientation and affect
Actions
o Replace the surfactant that is missing in the lungs of
neonates with RDS
Indications
o Rescue treatment of infants who have developed
RDS
Pharmacokinetics
o Begin to act immediately on instillation into the
trachea
o Metabolized in the lungs
Assess:
o History and Physical Exam and known allergy
o Time of birth and exact weight
o Temperature, Respirations, adventitious sounds,
endotracheal tube placement and patency, and chest
movements
o Blood pressure, pulse, and arterial pressure
o Blood gases and oxygen saturation
Actions-
o Works at the cellular level to inhibit the release of
histamine and inhibits the release of SRSA
Indications-Treatment of chronic bronchial asthma
o Exercise induced asthma
o Allergic rhinitis
o It is no longer considered part of the treatment
standards because of the availability of more specific
and safe
o Cromolyn (NasalCrom)
C. No contraindications